Provider Demographics
NPI:1821350414
Name:ARTIN, MARIA THERESA (CT)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:ARTIN
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 KINGSVIEW DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9562
Mailing Address - Country:US
Mailing Address - Phone:513-228-7800
Mailing Address - Fax:513-228-7848
Practice Address - Street 1:953 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2921
Practice Address - Country:US
Practice Address - Phone:937-383-4441
Practice Address - Fax:397-383-2916
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-1200265-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health